Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania Case Brief

Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania

140 S. Ct. 2367 | 207 L. Ed. 2d 819

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Takeaway

Background

The Affordable Care Act requires covered health plans to provide certain preventive services without cost sharing. For women, 42 U.S.C. § 300gg-13(a)(4) directs coverage of additional preventive care and screenings as provided for in comprehensive guidelines supported by the Health Resources and Services Administration (HRSA). The statute does not mention contraception. HRSA's 2011 guidelines nevertheless required coverage of FDA-approved contraceptive methods, sterilization, and related counseling—the regulatory contraceptive mandate.

Over time, the Departments of Health and Human Services, Labor, and Treasury created a narrow church exemption and then an accommodation for objecting religious nonprofits. Under the accommodation, an employer could certify its objection while its insurer or plan administrator separately supplied contraceptive coverage. The Little Sisters of the Poor, a Catholic religious order that operates homes for the elderly poor, believed that even using that accommodation would make them complicit in conduct forbidden by their faith. Their challenge was among the cases remanded in Zubik v. Burwell after the Court directed the Government to seek an approach that accommodated religious exercise while preserving contraceptive coverage.

In 2017, after concluding that a different accommodation was not feasible, the Departments issued interim final rules creating broader religious and moral exemptions. In 2018, following public comment, they finalized rules allowing employers with sincerely held religious objections—and certain employers with sincerely held moral objections—to opt out of providing contraceptive coverage. Pennsylvania and New Jersey challenged the rules under the Administrative Procedure Act (APA). The District Court preliminarily enjoined them nationwide, and the Third Circuit affirmed, holding that the Departments lacked statutory authority and had committed procedural APA violations. The Supreme Court reversed and directed that the nationwide preliminary injunction be dissolved.

Issues

Issue #1

Whether the Little Sisters needed to establish independent Article III standing to participate in the Government's appeal as intervenors.

Holding

No. Because the Federal Government had standing to appeal and the Little Sisters sought the same relief—the dissolution of the injunction—the Third Circuit erred by demanding independent standing from the Little Sisters.

Reasoning

An intervenor must independently establish Article III standing when it seeks relief broader than, or different from, the relief requested by the party that invoked the court's jurisdiction. That rule did not apply here because the Government properly invoked appellate jurisdiction and both the Government and the Little Sisters sought dissolution of the same injunction against the religious exemption.

Issue #2

Whether the ACA authorized the Departments and HRSA to create religious and moral exemptions from the regulatory contraceptive mandate.

Holding

Yes. The ACA gave HRSA broad discretion to define the relevant preventive-care guidelines, including discretion to create the challenged religious and moral exemptions.

Reasoning

Section 300gg-13(a)(4) requires coverage of additional women's preventive care and screenings “as provided for” in comprehensive guidelines supported by HRSA. The Court read that language as a broad delegation to determine the content and operation of those guidelines, rather than a narrow authorization merely to list covered services.

reasoning?